Light and lasers for vascular and skin diseases: From bench to clinic – An update

Abstract

The laser (light amplification by stimulated emission of radiation) is a device that emits light beams of specific wavelength and is able to transform other energies into electromagnetic radiation [1]. Depending on the medium they use, lasers can be solid-state lasers [ruby or neodymium:yttrium-aluminum garnet (Nd:YAG) lasers], liquid-state lasers (dye lasers), gas lasers (helium, heliumneon and excimer lasers) or semi-conductor lasers (also called diode lasers). The laser’s first medical use was to repair detached retinas by means of spot welding in ophthalmology [2]. However, dermatologists, especially Dr. Leon Goldman, played an important role in the further development and application of medical lasers. Goldman first used the laser in the field of dermatology to treat tattoos using a ruby laser, with 500-ms pulses [3]. As a result, he is often referred to as the “godfather of lasers in medicine and surgery” [4]. Light therapy, also called phototherapy or heliotherapy, classically refers to the use of ultraviolet (UV) light in the management of disease conditions. Phototherapy has been used for centuries to treat skin disorders. Most of the insights into the therapeutic benefit of phototherapy, that have been gained over time, have been related to observed effects of natural sunlight. It was not until the 20th century that artificial light sources were developed to utilize UV light for medical purposes. Niels Finsen was the first person to treat a cutaneous mycobacterial infection of the skin by the focused delivery of UV light for which he was awarded the Nobel Prize [5]. The development continued and in the middle of the 20th century, ultraviolet B (UVB) and psoralen plus ultraviolet A (PUVA) phototherapy were used, primarily for treatment of psoriasis. More recently further research has led to the application of broadband UVB (290–320 nm), narrowband UVB (311–313 nm), 308 nm excimer lasers, and UVA-1 (340–400 nm) irradiation. Laser and light technology and its use in dermatology is a rapidly advancing field. Laser and light sources are also being used in combination with pharmacological agents to optimize the therapeutic outcome [6]. This issue of Photonics & Lasers in Medicine presents some encouraging efforts in the application of lasers and light-based therapy especially in vascular diseases and dermatophyte fungi. Therefore, the present editorial aims to briefly discuss the use of lasers and light-based therapies for various skin conditions including vascular, fungal infections and other diseases such as inflammatory, premalignant and malignant lesions.